Overview
- California’s Medi‑Cal and Pennsylvania’s Medicaid now deny GLP‑1 prescriptions written solely for weight loss, keeping coverage only for conditions such as diabetes or certain comorbidities effective Jan. 1.
- Novo Nordisk’s FDA‑cleared Wegovy pill rolls out this month with cash prices of $149 for the two lowest doses and $299 for higher doses, with efficacy tied to strict daily dosing and some insured patients eligible for $25 copays.
- The Trump administration’s TrumpRx portal launches this month to route patients to manufacturer discounts, with injection costs expected to start around $350 a month and potentially decline to about $250 within two years, while Costco and Walmart continue cash‑price programs.
- Insurers are scaling back obesity‑drug benefits, leaving roughly three‑quarters of Medicaid enrollees without coverage for GLP‑1s prescribed for weight loss and pushing many lower‑income patients toward still‑costly self‑pay options.
- Manufacturing risks are drawing new scrutiny, with reports of about 14,000 kilograms of solvent waste per kilogram of GLP‑1 active ingredient, as startups like Constructive Bio pursue biological production and drugmakers test solvent‑reduction strategies.